老年性脑梗死病人饮食干预探讨

[目的]探讨老年性脑梗死病人的饮食相关问题和减少便秘发生的问题。[方法]饮食指导,分析饮食注意事项,进行便秘护理。[结果]本组87例病人只有7例发生便秘。[结论]做好老年性脑梗死病人的饮食护理对疾病的康复和预防便秘十分重要。     

饮食干预和脐周按摩对昏迷病人便秘的效果探讨

[目的]探讨饮食干预和脐周按摩对昏迷病人便秘的影响及作用.[方法]比较昏迷便秘病人进行饮食干预和脐周按摩前、后大便的次数、形状、需要采取护理措施协助排便的次数.[结果]对昏迷便秘病人进行饮食干预和脐周按摩后,大便次数增多,大便质地变软,需要采取护理措施协助排便的次数减少.[结论]昏迷便秘病人进行饮食干预和脐周按摩,可有效地改善或缓解病人便秘状况.     

饮食干预和脐周按摩对昏迷病人便秘的效果探讨

[目的]探讨饮食干预和脐周按摩对昏迷病人便秘的影响及作用.[方法]比较昏迷便秘病人进行饮食干预和脐周按摩前、后大便的次数、形状、需要采取护理措施协助排便的次数.[结果]对昏迷便秘病人进行饮食干预和脐周按摩后,大便次数增多,大便质地变软,需要采取护理措施协助排便的次数减少.[结论]昏迷便秘病人进行饮食干预和脐周按摩,可有效地改善或缓解病人便秘状况.     

DAJ-5B型艾灸治疗仪对脑梗死病人便秘发生率的影响及分析

[目的]观察DAJ-5B型艾灸治疗仪对脑梗死病人便秘发生率的影响.[方法]将180例脑梗死病人随机分为观察组与对照组各90例,对照组采用常规护理方法,观察组在常规护理方法的基础上加用DAJ-5B型艾灸治疗仪治疗,比较两组病人便秘发生率及便秘症状评分情况.[结果]观察组便秘发生率低于对照组（P＜0.05）,排便困难、粪便性状、下坠感、排便频率、腹胀便秘症状明显缓解,与对照组比较差异有统计学意义（P＜0.05）.[结论]DAJ-5B型艾灸治疗仪在脑梗死病人中的应用能有效降低脑梗死病人便秘的发生率,缓解便秘症状.     

循证护理在脑卒中卧床病人便秘中的应用

[目的]对脑卒中卧床便秘病人展开循证护理.[方法]根据159例脑卒中卧床便秘病人产生便秘具体情况,提出护理问题,收集相关研究证据,结合实际实施心理护理、饮食护理、活动指导、养成规律排便习惯、健康教育等护理措施.[结果]2 d内排便69例,4 d内排便87例,3例戴手套抠出干硬粪便.[结论]对并发便秘的脑卒中卧床病人实施循证护理治疗,效果显著,能有效解除病人便秘带来的痛苦.     

综合护理干预对解除骨科卧床病人便秘的效果观察

[目的]观察综合护理干预对解除骨科卧床病人便秘的效果.[方法]将184例骨科便秘病人随机分为观察组和对照组各92例,对照组病人给予番泻叶进行治疗,观察组病人给予提肛运动、腹部按摩、心理疏导、饮水饮食指导等护理干预.比较两组病人便秘治疗效果、腹泻、腹痛不良反应的发生情况.[结果] 观察组病人便秘治疗效果优于对照组（P＜0.05）;观察组病人腹泻、腹痛不良反应的发生率低于对照组（P＜0.05）.[结论] 综合护理能够有效解除骨科卧床病人便秘,减少病人的不良反应.     

综合护理干预对重型颅脑损伤病人并发便秘的影响

[目的]观察护理干预对重型颅脑损伤病人并发便秘的影响.[方法]将100例重型颅脑损伤病人随机分为观察组与对照组,每组50例,对照组采取神经外科常规护理,观察组采取综合护理干预.观察并比较两组病人便秘发生情况.[结果]观察组便秘发生率为10%,对照组便秘发生率为48%,两组比较差异有统计学意义(P＜0.05).[结论]护理干预能有效减少重型颅脑损伤病人便秘的发生.     

妊娠期便秘非药物护理干预的初步探讨

[目的]初步探讨妊娠期便秘的非药物护理干预措施.[方法]回顾性分析90例妊娠期便秘病人的临床资料.[结果]本组81例病人便秘症状明显改善,9例无明显改善病人经物理治疗后便秘症状得到较好控制.[结论]妊娠期便秘病人经非药物综合护理可改善便秘症状.     

肿瘤化疗病人发生便秘的相关因素及护理对策

[目的]恢复肿瘤便秘病人正常排便形态,使其顺利完成化疗过程.[方法]对96例病人因化疗所致便秘的原因进行分析,进行心理干预、饮食指导及药物治疗.[结果]61例病人能在2 d或3 d内恢复正常排便形态,32例病人能在4 d或5 d内恢复正常排便形态,3例病人能在6 d内恢复正常排便形态.[结论]护理人员重视肿瘤化疗所致便秘的并发症,并及时采取有效的预防和护理措施,能减轻病人的痛苦,使其主动配合各项治疗护理,对促进康复、提高肿瘤护理水平有较大的帮助.     

临床护理路径在预防脊柱骨折病人

[目的]观察临床护理路径在预防脊柱骨折病人便秘中的应用效果.[方法]将80例脊柱骨折病人随机分为观察组和对照组,每组40例,对照组采取传统护理方法,观察组制订临床护理路径干预.比较两组病人疾病相关知识掌握情况、病人的满意度、便秘发生情况及通便药物使用情况.[结果]观察组病人疾病相关知识掌握情况优于对照组;观察组病人的满意度高于对照组;观察组病人便秘发生及使用通便药物低于对照组.[结论]应用临床护理路径可预防脊柱骨折病人便秘的发生.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.